Diphyllobothrium Infection

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Diphyllobothriasis is defined as infection with the cestode Diphyllobothrium latum or other Diphyllobothrium species (eg, Diphyllobothrium nihonkaiense). It is endemic in areas where humans frequently consume raw or pickled fish.

A full-grown Diphyllobothrium worm can range from 1-15 m in length and is the longest human tapeworm. It consists of up to 3000-4000 proglottids. The scolex, as noted, has 2 sucking grooves, also called bothria. Proglottids are typically wider than they are long, which is why D latum is called the broad tapeworm. One study demonstrated that when a mixture of vitamin B-12 and gastric juice was placed in the ileum, a hematologic remission resulted; such a remission did not occur when the mixture was taken orally. These results suggest that D latumpreferentially absorbs vitamin B-12 in the blood, preventing vitamin B-12-IF complexes from reaching receptors in the small bowel.

The standard treatment for diphyllobothriasis, as well as many other tapeworm infections is a single dose of Praziquantel, 5–10 mg/kg PO once for both adults and children. An alternative treatment is Niclosamide, 2 g PO once for adults or 50 mg/kg PO once. One should note that Praziquantel is not FDA approved for this indication and Niclosamide is not available for human use in the United States.

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